Abdominal tuberculosis in a low-incidence country: a single centre experience on 13 patients invstigated with 18F-FDG PET/CT

Giacomo Vandi


To assess role of 18F-FDG PET in the diagnosis of abdominal tuberculosis (ATB).
MATERIALS AND METHODS: Clinical records, 18F-FDG PET/CT findings of patients diagnosed with ATB between January 2013 and January 2016 at Infectious Diseases Unit were retrospectively analyzed.
289 pts were diagnosed with TB. Among them 23 had ATB. 13/23 underwent 18F-FDG PET and were included in the analysis.

Clinical characteristics: 7 women, 6 men; median age 39 years. 12 foreigners, 1 Italian, 2 HIV+. All pts had no past history of TB.

Common symptoms were: loss of body weight (12), abdominal pain (10), night sweats (7), fever (6); ascites (5), diarrhea (1).

Clinical requests for imaging were: differential diagnosis between cancer and TB.
Abdominal nodes were identified in 11 pts, peritoneal involvement in 9 pts, mimicking peritoneal carcinosis. Gastrointestinal-tract was affected in 2. Liver was involved in 1 pt. Extra-abdominal localizations were depicted 9 pts.
Based on PET findings, it was possible to perform focused biopsy in all patients that led to bacteriological TB confirmation in 10/13 pts and histological confirmation in 3/13
ATB diagnosis is insidious for non-specific appearance mimicking malignant/other inflammatory diseases. PET seems to play an important role in ATB diagnosis, identifying the involved sites for focused biopsy. Larger studies are needed to confirm our observations.

Simone Agnello
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